Surgical ligature dispenser



vJuly 7, 1959 G. M. CARVER, JR, :1- AL 2,893,548

' SURGICAL LIGATURE DISPENSER Filed Dec. 28; 1956 cu E FIG.

INVENTOR GORDON M. CARVER, JR.

BY WILLIAM BARBER c AIZTORN EY Uaiwd States at h Q 2,893,548 SURGICALLIGATURE DISPENSER Gordon M. Carver, Jr. and William Barber, Durham,N.C., assignors to American Cyanamid Company, New ,-York, N.Y.,' acorporation of Maine "This, invention relates to a ligature dispenser.

The problem of dispensing ligature to the surgeon as he uses them is avery serious one. The surgeon must hold the ligature .dispenser in hishand, he must be able to exert a very strong pull when tying ofi heavystructures, such as large arteries, and it is also vital that theligature does not unwind from its reel and snarl or kink, resultingeither in delay in the operating room or to weakened spots in theligature. There is involved the risk of dropping it outside of thesterile field and, what is even more important, imposing aseriouscramping strain on the surgeons hand which, in a long operation, canbe avery serious problem. In the past, ligature reels have been used eitherplain or in capped containers, through a small opening in which theligature passes. While the latter is a big improvement as far asunwanted uncoiling of the ligature is concerned, it is still necessaryfor the surgeon at all times to grip the ligature container. g I Anotherfeature which is necessary is that-the dispens er be capable ofsterilization and that it be possible quickly to insert fresh reels ofligature either where the 2,893,548 Patented July 7, 1959 ice tionalsmall part, a snap flange, which can be dropped and which is one morepart to be sterilized and sterilization of casings and constant use mayresult in loosening of an end cap. A better modification, which is thepreferred one in the present invention, is to provide a casing open atone end and with a small hole at the other end just slightly smallerthan the small end of the spindle, which is then introduced therethroughand snaps into position. In this preferred modification the end of thecasing performs the functions both of a casing end and of a spindleflange. Other modifications of spindle design and casing form areincluded in the present invention.

The invention will be described in greater detail. in conjunction withthe drawingsin which:

Fig. 1 is an exploded view .of a preferred form of dispenser;

Fig. 2 is an elevation, partly broken away, of the dispenser package inassembled form;

Fig. 3 is an exploded view of a modified form 0 spindle; and,

Fig. 4 is an elevation, partly broken away, of an assembled dispensingpackage using the spindle construction of Fig. 3.

The dispenser illustrated in Figs. 1 and 2 includes a cylindrical.casing 1 having an open end 2 and a small opening 3 at the other end.Inthe center there is rigidly attached to the casing a split ring 4oriented in the longitudinal plane of the casing and adapted to fit overthe middle finger of a surgeon. A longitudinal slot 5 is providedthrough which the end of a ligature passes. A

spindle, fitting in the cylindrical casing, is provided with a ligatureis used up of where it is necessary to use ligatures tection againstpremature unwinding of the ligature and V can be reloaded easily andquickly. The ability to use standard ligature reels which are wound oncylindrical tubes, usually of fiber, is important not only from thestandpoint of economy using standard ligature reels which can bewoundcheaply but the use of standard reels improves the protection againstinfection. Ligature reels are wound commercially either under asepticconditions or are sterilizedafter winding, depending on the ligaturematerial, and are packaged-so they are maintained in a sterilecondition. Specially wound bobbins or other types of equipment whichhave to be wound in the hospital present a serious problem ofcomplication and arefar more diflicult'to sterilize.

Essentially the dispenser package of the present invention includes acylindrical casing havinga strong" ring or partial .ring attachedthereto which fits one of the surgeons fingers, usually the middlefinger and provided-with a'longitudi'ual slot through which the'ligaturepassesas it unwinds. Inside the casing there is a spindle having aflange at one end and a spring fastening, such as a slot andcircumferential groove, at the other end. The standard commercialligature reel is slipped on the spindle be fore the latter is insertedin the casing. In order to prevent premature unwinding of the ligaturethere must be a flange, or its equivalent, at the other end of thespindle. One way to handle the problem is to snap a removable flangeover the small end of the spindle after the ligature reel has beenmounted thereon. In such a case a casing closed at one end and with asuitable cap at the other end is used. This form, while operable anduseful, has some disadvantages. For one thing, it requires anaddiperiods of time.

small diameter. cylindrical portion 6 on which a suture reel 7 can heslid. One end of the spindle carries a flange 8 which fits'snugly intothe large opening 2 of the dispenser casing. The other end is slotted at9 and provided with a groove 10.. The end of the slotted portion acts asa collar and is beveled sothat it can slide through the small opening 3in the closed end of the dispenser casing and snap tight. In operationthe tubular suture reel is slipped over the spindle, the end of theligature fed through the slot 5 of the case, and the spindle and reelinserted into the casing, the slotted end being pushed through the smallopening 3. Fig. 2 shows the assembled casing with the ligature endprotruding through the slot.

.As there are in eifect two flanges at the ends of the ligature reel,one being the large flange 8 of the spindle and the other the closed endof the dispenser casing, coils of ligature.cannot unwind prematurely andvslip ofi the reel. There is thus no possibility of snarling or kinkingof the ligature, and yet it is always ready in the surgeons hand foruse. When wearing the dispenser on his middle finger the surgeon doesnot have to grasp it continually and there is no danger of his fingers.being cramped by gripping a separate ligature reel for long Fig s. '3'and 4, in which the same parts bear the same reference numerals,illustrate a' modified form of dispenserpackage. Here the dispensercasing -1-is pro vided with a closed end 11, the spindle 6 has a largeflange 8, and there is provided a second flange 12 which is snapped onthe slotted end of the spindle after the ligature reel has been mountedthereon. This flange has a main flange body 13 and a short collar 14which actually engages the slotted end. The dispenser casing is alsoprovided with an end cap 15. After the ligature reel is mounted on thespindle and the removable flange snapped on, the ligature end is passedthrough the slot 5 and the spindle carrying the ligature reel isinserted through the open end of the casing. Thereupon the cap isslipped over the open end and the assembled dispensing package is of theform illustrated in Fig. 4. This modification has many ofthe advantagesof the preferred modification illustrated in Figs. 1 and 2 but requiresa cap and a separate removable flange. Once the package is assembled,however, the surgeon has the same convenience in wearing and using it. v

The advantages of the dispensing package of the present invention arenot limited to operations where the ligature is in constant use.Sometimes a surgeon may have to use the ligature during only a part ofthe opera,- tion. With ordinary ligature reels, they must be set downwith a possibility of misplacement or delay in picking up, whereas thedispensing package ofthepr'esent invention can, if necessary, be wornbythejsurgeon throughout the operation, .as the ,fing'er'spf the handwearing the dispenser are .freejto grasp any instruments needed. Yet,theligature is always at hand and can be used without delay. I

I The particular material used in making. the casing is not critical. Itmust, of course, be strong enough a'nd rigid enough for the mechanicalrequirements of its operation and it must also resist corrosion andother conditions encountered in sterilization. Very satisfactory casingscan be made of chrome-plated metal. Stainless steel may also be used,but the attachment of the ring by welding is not as smooth, and so thedispenser package is less attractive. However, stainless steel has theadvantage that its corrosion resistance is not in the ,form of aplating. It is possible to use plastics of adequate heat resistance towithstand, the sterilization but a thicker Wallis then required andnormally non-corroding metal casings are preferable. V r The spindle canbe made of any material which has sufficient springiness for the slottedend. Thus, itcan be made of metal which is either plated ornon-corroding, such as stainless steel. However, a metal spindle isheavier and a plastic such as nylon which has adequate strength andspringiness is preferred.

We claim: l. A two-piece readily sterilizable ligature dispenser packagecomprising in combination: a dispenser casing having a cylindrical bodywhich has an open end, and a partially closed end having a central holetherein, having rigidly attached to said body at approximately'thecenter thereof a finger ring of a size adapted to surround an adult,human middle finger and oriented so that the plane of the ring issubstantially parallel with the longitudinal axis of the casing, saidcasing having a longitudinal slot in the cylindrical body thereof, a.ligature on a reel in said casing, with the end of the ligatureextending through said slot, and a spindle having a cylindricalbodyportion of a size adapted to be fitted into the ligature reel and fittedin said reel, said spindle having a flange at one end inserted in thecasing and fitting snugly in the open end thereof, said spindle having agroove at the end opposed to the flange, and an axial slot extendingpart way along the said cylindrical body portion fromfsaid grooved end,said groove snap fitting into the central hole in the restricted end ofthe casing.

2. A two-piece readily 'sterilizable ligature dispenser packagecomprising in combination: a dispenser Icasing having a cylindricalbodywhich has an open end,.and a partially closed end having a central holetherein, having rigidly attached to said body at approximately thecenter thereof a finger ring of a size adapted to "surround an adult,human middle finger and oriented so that the plane of the ring issubstantially parallel with the longitudinal axis of the casing, saidcasing having a longitudinal slot in the cylindrical body thereof, aligature on a reel in said casing, with the end of the ligatureextending through said slot, and a spindle of springy plastic materialhaving a cylindrical body portion of a size adapted to be fitted intothe ligature reel and fitted in said reel, said spindle having a flangeat one end inserted in the casing and fitting snugly in the open endthereof, said spindle having a groove at the end opposed to the flange,and an axial slot extending part way along the said cylindrical bodyportion from said grooved end, said groove snap fitting into the centralhole in the restricted end of the casing.

3. A readily, sterilizable ligature dispenserpackage comprising .incombination: a dispenser casing having a cylindrical ,body which has anopen end and a closed end and having rigidly attached to said body atapproximately the center thereof a finger ring of a size adapted tosurround an adult, human middle finger and oriented so that the plane ofthe ring is substantially parallel with thelongitudinal axis of thecasing,.s aid casing vhaving a longitudinal slot in the cylindrical bodythereof; aligature on a reel in said casing, with the end of theligature v extending through said slot, a spindle having a cylindrical Iattached to the other end of said spindle, anda removable cap closingthe open end of the cylindrical body.

4. A readily sterilizable ligature dispenser package comprisingincombination: a dispenser casing having a cylindrical body which hasone open end, and having rigidly attached to said body at approximatelythe center thereof a finger ring of a size adapted to surround an adult,human middle finger and oriented so that the plane of the ring issubstantially parallel with the longitudinal axis of the casing, saidcasing having a longitudinal slot in the cylindrical body thereof, aligature on a reel in said casing, with the end of the ligatureextending through said slot, a spindle having a cylindrical body portionof a size adapted to be fitted in said reel and fitted in said reel,said spindle having a flange and at one end inserted in the casing andfitting in the open end thereof, removable flanging means engaging theother end of the spindle, and means to retain the spindle having thereel and ligature mounted thereon in the casing.

References Cited in the file of this patent UNITED STATES PATENTS550,701 Wardwell Dec. 3, 1895 562,173 Daniels .Q June 16, 1896 573,563Yeakel Dec. 22', 1896 686,324 McKay Nov. '12, 1901 902,109 Powell Oct.-27, 1908 1,856,619 Carsey May}, 1932 2,681,772 Charney June 22, I954

